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103
Compared with the previous year, more notifications were
received during 1966 relating to malformations of the alimentary
and urogenital systems while there were fewer central nervous
system defects. The number of other malformations indicated no
considerable variation on the 1965 figures.
Anencephaly—Of all the malformations recorded, most research
has been carried out in respect of anencephaly perhaps because this
is a condition which is easily and reliably identified. Statistics with
regard to this defect, therefore, tend to reflect the true position.
In Greenwich, the rate per 1,000 total notified births was 1.59
compared with a figure of 1.66 for England and Wales and 1.09
for the South East Region.
Mongolism—This is another reasonably easily identified defect
with a local rate of 1.06. Rates for England and Wales and the
South East Region are 0.67 and 0.61 respectively.
'At Risk' Register
Certain familiar or acquired factors in pre-natal, perinatal or
post-natal life are now established as giving rise to greater than
average risks of a baby having or developing mental or physical
abnormalities.
The earlier such abnormalities are detected, the sooner may
treatment or remedial action be initiated, usually with a greater
degree of success than if diagnosis is delayed.
In order to ensure such early detection, all notifications of
discharge of a mother from a maternity unit or the care of a midwife
are perused to select those whose infants are liable to develop such
a handicap. These infants are reviewed regularly on the 'At Risk'
register with the gleaning of information from various sources.
After a variable period the name of a child who is found to be
developing normally is removed from the register and that of a
child who is found to have an abnormality is transferred to the
Handicapped Register.
During 1966, as in 1965, approximately one third of the children
born to residents in the Borough were "at risk", although happily
the majority developed normally. At the end of 1966 there were
1,486 children listed in the register compared with 933 at 31st
December, 1965.
The 'At Risk' register cannot, of course, guarantee to find
every case of hidden handicap, but it does encourage careful observation
in all those who are working with infants. It is also important
that parents should not be made unduly anxious when their baby is
on the register and that risks are not exaggerated, particularly in the
occasional case where a baby is to be placed for adoption.